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    Effects of treatment regimens on survival in patients with malignant pleural mesothelioma.
    (2013) Abakay A.; Abakay O.; Tanrikulu A.C.; Sezgi C.; Sen H.; Kaya H.; Kucukoner M.
    In this study, we aimed to investigate the factors affecting the survival of patients with malignant pleural mesothelioma (MPM) according to their treatment regimens, including best supportive care (BSC), chemotherapy, surgical group and multimodality (MM) therapy. A retrospective analysis was performed on clinical data and treatment outcomes of 400 patients registered in our hospital with MPM between January 1989 and April 2010. Mean age (p < 0.001), presence of asbestos exposure (p = 0.0014), presence of smoking history (p < 0.001), Karnofsky performance status (p < 0.001), histological subtype (p = 0.034) and stage (p < 0.001) variables were found to be significantly different among the four treatment regimens. Mean survival time of all patients was 12.32 months. Mean survival time 10.5 months for the BSC group, 15.7 for the surgical group, 16.02 for the chemotherapy group, and 26.55 for the MM group. There were significant differences in mean survival time among the four treatment regimens. In addition, a significant difference was found in survival time between the two chemotherapy groups (p = 0.032). Mean survival time for cisplatin + gemcitabine was found to be 14.49 months and for cisplatin + pemetrexed, 18.34 months. The MM group had better survival rates than the other groups. The new chemotherapy combination, cisplatin + pemetrexed, can be helpful in improving survival time.      
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    Insulin resistance in liver cirrhosis
    (2011) Goral V.; Atalay R.; Kucukoner M.
    [No abstract available]
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    Mast cells count and serum cytokine levels in patients with irritable bowel syndrome
    (2010) Goral V.; Kucukoner M.; Buyukbayram H.
    Background/Aims: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder. Psychological factors and subtle histopathological changes have been implicated in IBS. In some studies, mast cell infiltration has been determined in colon mucosa of the patients with IBS. The aim of this study was to investigate the relationship between mast cell counts and cytokine levels and IBS. Methodology: 72 consecutive IBS patients fulfilling the Rome III criteria and 50 asymptomatic healthy controls underwent colonoscopic biopsy. 15 patients in diarrhea-predominant IBS group which were performed colonoscopy were made a biopsy from caecum, other 25 patients in diarrhea-predominant IBS and 32 patients in constipation predominant IBS were performed a biopsy from rectum. Additionally, serum cytokines were analysed in the patients with IBS and in control group. Results: The results showed significantly increased mast cells in the IBS-diarrhea group compared to IBS-constipation and the control groups (p<0.0001). The statistical analysis of the inflammatory cytokine data obtained in the present study showed significantly higher levels for the sIL-2 receptor in the IBS-diarrhea group compared to other groups. Conclusions: Histopathologic and laboratory data demonstrate low-grade mucosal inflammation in a subset of patients with IBS. Mast cells and cytokines may be related to the pathophysiologic mechanism of IBS. © H.G.E. Update Medical Publishing S.A.
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    Significance of hormone receptor status in comparison of 18F-FDG-PET/CT and 99mTc-MDP bone scintigraphy for evaluating bone metastases in patients with breast cancer: Single center experience
    (Asian Pacific Organization for Cancer Prevention, 2015) Teke F.; Teke M.; Inal A.; Kaplan M.A.; Kucukoner M.; Aksu R.; Urakci Z.
    Background: Fluorine-18 deoxyglucose positron emission tomography computed tomography (18F-FDG-PET/CT) and bone scintigraphy (BS) are widely used for the detection of bone involvement. The optimal imaging modality for the detection of bone metastases in hormone receptor positive (+) and negative (-) groups of breast cancer remains ambiguous. Materials and Methods: Sixty-two patients with breast cancer, who had undergone both 18F-FDG-PET/CT and BS, being eventually diagnosed as having bone metastases, were enrolled in this study. Results: 18F-FDG-PET/CT had higher sensitivity and specificity than BS. Our data showed that 18F-FDG-PET/CT had a sensitivity of 93.4% and a specificity of 99.4%, whiel for BS they were 84.5%, and 89.6% in the diagnosis of bone metastases. x statistics were calculated for 18F-FDGPET/CT and BS. The x-value was 0.65 between 18F-FDG-PET/CT and BS in all patients. On the other hand, the x-values were 0.70 in the hormone receptor (+) group, and 0.51 in hormone receptor (-) group. The x-values suggested excellent agreement between all patient and hormone receptor (+) groups, while the x-values suggested good agreement in the hormone receptor (-) group. Conclusions: The sensitivity and specificity for 18F-FDG-PET/CT were higher than BS in the screening of metastatic bone lesions in all patients. Similarly 18F-FDG-PET/CT had higher sensitivity and specificity in hormone receptor (+) and (-) groups.
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    Trastuzumab-based retreatment after lapatinib in heavily pretreated HER2 positive metastatic breast cancer: An anatolian society of medical oncology study
    (Asian Pacific Organization for Cancer Prevention, 2015) Uncu D.; Bayoglu I.V.; Arslan U.Y.; Kucukoner M.; Artac M.; Koca D.; Oguz A.
    Background: For HER2 positive metastatic breast cancer (MBC), continuing anti-HER2 therapy beyond progression is associated with improved outcome. However retreatment with trastuzumab after lapatinib progression is controversial. We retrospectively analyzed the efficacy of trastuzumab-based chemotherapy in HER2+ metastatic breast cancer patients whose disease progressed after lapatinib. Materials and Methods: Between October 2010 and May 2013, 54 patients whose disease progressed after lapatinib were retreated with trastuzumab-based chemotherapy. Efficacy and toxicity results were evaluated retrospectively. Results: The median age of patients was 46 (range 27-67). Fourteen patients (26%) had metastases at the time of diagnosis. All of the patients had received trastuzumab in an adjuvant or metastatic setting, while 16 (30%) had received two lines of trastuzumab. All patients had received lapatinib plus capecitabine. The median chemotherapy line for the metastatic setting was 2 (range 1-7). Cranial metastases were identified in 27 (50%) patients. 53 patients received trastuzumab-based chemotherapy following lapatinib progression while one patient received trastuzumab monotherapy. Combination chemotherapy consisted of navelbin (n=33), taxane (n=10), gemcitabine (n=2), platinum (n=2) and platinum with taxane (n=6). The median treatment cycle was 5 (range 1-44). Among 49 patients assessed for response 2 (4%) showed CR, 12 (25%) PR, 11 (22%) SD and 24 (49%) disease progression. Asymptomatic cardiotoxicity was reported in 2 (4%) of the patients. At a median follow-up of 9 months (1-39), median progression-free survival was 5 months (95% CI 4.1-5.9) and median overall survival was 10 months (95% CI 6.9-13.0). PFS and OS were not affected by the absence/presence of cranial metastases. Conclusions: Retreatment with trastuzumab-based therapy after lapatinib progression showed efficacy in heavily treated MBC patients.